behavior. Similarly, the National Campaign to Prevent Teen Pregnancy communicates messages about sexual responsibility and advocates use of safer sexual behaviors to teens. In contrast, messages intended for parents stress the importance of having open discussions with their children about issues related to sex, including prevention of pregnancy and sexually transmitted diseases.

Heterogeneity in Causes and Correlates of Behavior (and Thus in Message Strategies)

Because perceived benefits and barriers to behavior change may differ across audience segments, effective communication campaigns for diverse audiences should be adapted to appropriately frame messages to address the audience’s perceived risks, costs, benefits, and social pressures related to the desired behavior change. Several examples of campaigns from this review promote the same behavioral goal through different strategies for diverse populations, including the Folic Acid Campaign. This campaign has developed different communication materials for women, focusing on the more immediate benefits to infants among women contemplating pregnancy, and the longer term benefits for those not contemplating pregnancy. Similarly, the Campaign to Prevent Teen Pregnancy has different communication strategies and materials for teenage boys and girls, emphasizing gender-specific rewards and barriers.

The National Diabetes Education Program is adapted to address the major ethnic groups in the United States. Messages promote identified cultural values that encourage diabetes self-care (cultural incentives) and challenge cultural traditions that inhibit diabetes care-related behaviors (cultural barriers). For example, messages for Hispanics to control diabetes were developed to counter the fatalistic belief that diabetes complications are inevitable, and messages for Native American/Alaskan Native populations emphasize the importance of growing older to “be around” for younger generations and to pass on traditions (Centers for Disease Control and Prevention, 1999).